Medical editor

Prostate cancer

Prostate cancer is the most common cancer form in men in most contries of the western world. The disease development varies, and it can take up to twenty years from when cell changes start via prostatic intraepithelial neoplasia (PIN) and indolent (latent) cancer and develop into clinical cancer.

The tumor types of prostate cancer differ in levels of malignancy. Therefore, the treatment schemes differ from no treatment to comprehensive multimodal treatment. To achieve optimal treatment results, it is important that these patients are evaluated by multidisciplinary teams including an urologist, oncologist, radiologist, and pathologist.

During the last 10–20 years, PSA, or prostate specific antigen, has been used for early detection of prostate diseases, including cancer. This has often led to detection of cancer at earlier stages during the course of the disease. The PSA level, measured by a blood test, is often high in the presence of prostate cancer. However, a high PSA reading is not specific for cancer.

There are many controversial aspects in the treatment of prostate cancer. One of the questions is whether to detect the disease early by PSA-screening or whether the disease’s natural, untreated course is benign enough that curative treatment of early cancer with it’s subsequent serious side effects is unethical.

Incidence

Compared to other cancers, prostate cancer is fairly common and represents 10.7% of all new cancer cases in the United States.The number of new cases of prostate cancer was 129.4 per 100,000 men per year based on 2009-2013 cases. Prostate cancer is more common in older men than younger men and is most frequently diagnosed among men aged 65-74.

In 2017, it is estimated to be 161,360 new cases of prostate cancer in the United States (6).